• Illegal sale, purchase of convalescent plasma rampant
• 5,090 Covid-19 cases, 117 deaths recorded in 24 hours
• ‘Smart lockdown’ imposed in four provinces

ISLAMABAD: While illegal sale and purchase of convalescent plasma (CP) is going on across the country, the Ministry of National Health Services (NHS) on Tuesday announced that plasma therapy should not be considered as a cure for coronavirus.

The ministry warned that there could be serious side effects of plasma therapy, including febrile reactions [temperature increase and sometimes headache and back pain], allergic reactions, transfusion-associated circulatory overload, bronchospasm, transfusion-related acute lung injury and transmission of diseases like HIV, hepatitis B and C and others.

The country reported 5,090 Covid-19 cases and 117 deaths over the past 24 hours, taking the national tally of cases to 151,953 and deaths to 2,900.

It is worth mentioning that some of the people who have recovered from coronavirus are demanding tens of thousands of rupees for the plasma. Some labs have also started illegal business of plasma as it is believed that antibodies formed in the blood of the Covid-19 victims and, once they recover from the disease, those antibodies can help other patients to recover.

According to guidelines available with Dawn, since CP is still an experimental therapy, it can only be safely used under controlled settings as part of research protocol. The principal investigator of the research should obtain approval for his/her protocol and must get the health facility approved by the NHS ministry in which the therapy can be initiated under supervision. Only app­roved hospitals are all­owed to enroll their Covid-19 patients in clinical trials which have been cleared by the relevant research regulatory authorities.

A Covid-19 patient enro­lled in a permitted “clinical trial” can be eligible for receiving the investigational therapy i.e. CP under supervision of a qualified physician in an approved health facility. There could be various eligibility and ineligibility criteria based on the “trial protocol”.

Through the guidelines, the public has been informed that CP use is one of the int­erventions currently under investigation in Pakistan. However, at the moment, there are insufficient data to recommend either for or against the use of Covid-19 convalescent plasma as a standard therapy.

“Realising the dire need of effective treatment regimens for Covid-19, the government has mandated the Drug Regulatory Authority of Pakistan (Drap) to oversee testing new technologies and interventions. Clinical trials are currently under way to test the use of convalescent plasma as an investigational treatment in Covid-19 patients. Hospitals and physicians taking part in the trials can enroll their Covid-19 patients who fulfil the eligibility criteria for entering into the study.

“Individuals, who have fully recovered from Covid-19 are asymptomatic for at least two weeks and are willing to donate plasma, can contact helpline 1166 for guidance for nearby accredited plasma donation centres and hospitals offering CP to patients under approved protocols,” the guidelines state.

“The public is advised to contact the treating physician/hospital for information regarding the trial in progress and not to be exploited by paying money in purchasing plasma from different blood banks/hospitals. Public and physicians are advised to keep themselves informed about the clinical guidance on judicious use of convalescent plasma for Covid-19 patients in current pandemic that will be issued by the Ministry of Health from time to time,” the guidelines add.

According to an official statement issued by the NHS ministry, plasma therapy should not be considered as a cure for Covid-19 as it is in the clinical trial phase, across the globe, after approval by the United States Food and Drug Administration.

“Till date no medicine has been invented which would be considered as a cure for the disease. Even plasma therapy is also in the phase of clinical trial. People are advised in their best interest that they should not try to buy CP from private labs as according to rules plasma can only be donated,” it states.

“So far it is proved that the plasma therapy does not work on the patients who remained on ventilators for seven days or more. There can be side effects of plasma therapy so it should not be in the absence of a qualified doctor. Do not listen to the private hospitals and labs which have been selling the plasma,” the statement adds.

It is worth mentioning that the Clinical Study Committee of Drap had on April 9 allowed clinical trials of convalescent plasma for the purpose of passive immunisation during the Covid-19 pandemic in the country.

NHS ministry’s spokesman Sajid Shah, while citing reports, said the illegal business of sale and purchase of plasma was going on across the country. “It is unfortunate that some elements try to get financial benefit from pandemics and crises. Donors should remember that saving one life is as better as saving the whole humanity,” he said.

Covid-19 tests

According to data of the National Command and Operation center (NCOC), so far 922,665 Covid-19 tests have been conducted across the country. The most number of tests — per million population — have been conducted in the federal capital. Overall 83,693 tests have been conducted in Islamabad, 366,435 in Punjab, 307,412 in Sindh, 104,257 in Khyber Pakhtunkhwa, 38,196 tests in Balochistan and 11,290 in Azad Kashmir.

Smart lockdown

The Punjab government has decided to partially im­­pose smart lockdown in sev­en of its major cities — Lah­ore, Rawal­pi­n­­di, Faisal­ab­­ad, Multan, Guj­ranwala, Sia­­l­­­kot, and Gujrat — to stop the spread of coronavirus.

Lockdown in Lahore star­ted immediately (Tuesday mid­­night) whereas other six cities will follow suit by Wed­nesday (today) midnight.

In Sindh, administrations of five districts imposed smart lockdown in certain potential Covid-19 hotspots. The deputy commissioners of Hyderabad, Sukkur, Jam­shoro, Kamber-Shahdadkot and Matiari enforced the curbs for 14 to three days. Karachi Com­missioner Ifti­khar Shall­wani said the ad­­ministration was in the process of identifying the areas in the city to enforce smart lockdown.

The KP government imposed smart lockdown in at least 10 districts, including Peshawar.

The Balochistan government extended smart lockdown for another 15 days in the province.

Published in Dawn, June 17th, 2020